[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-115-1-medical-surgical-024":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"lastmod":62},"內外科護理學","medical-surgical",{"id":7,"webId":8,"year":9,"session":10,"subject":4,"number":11,"stem":12,"options":13,"answer":18,"answerNote":19,"images":20,"explanation":21,"explanationDeep":22,"topics":23,"freq":10},"nurse-115-1-內外科護理學-024","nurse-115-1-medical-surgical-024",115,1,24,"王老太太意識恢復後，針對其目前的問題，下列護理措施何者正確？",{"A":14,"B":15,"C":16,"D":17},"鼓勵多喝牛奶","限制水份補充","給與Allopurinol藥物治療","給與Zometa藥物治療","D",null,[],"本題考點是高血鈣的處置藥理。依雙磷酸鹽類的作用機轉,Zometa(zoledronic acid)會吸附於骨表面並抑制蝕骨細胞活性與凋亡誘導,減少骨質破壞與鈣離子釋出,能同時降低血鈣並減緩骨骼疼痛與病理性骨折風險,正對應骨髓瘤溶骨造成高血鈣的病因,選 D。A 錯:牛奶富含鈣質,會使血鈣更高。B 錯:治療原則是充足水分以促進尿鈣排出並保護腎小管,限水會加重濃度上升與腎損傷。C 錯:Allopurinol 抑制尿酸生成,用於高尿酸與痛風,對血鈣無作用。","高血鈣治療可依「稀釋、排出、抑制吸收」三層記憶:先以生理食鹽水擴充血容量稀釋並促進腎排鈣,必要時加迴圈型利尿劑增加鈣排出(thiazide 類反而增加鈣再吸收,屬禁忌),再用雙磷酸鹽或 calcitonin 抑制骨質釋鈣,calcitonin 起效快但作用短,雙磷酸鹽起效慢而持久,兩者常互補。雙磷酸鹽的常考不良反應是顎骨壞死與腎功能惡化,故用藥前評估腎功能與口腔狀況、給藥採緩慢靜脈輸注。骨髓瘤病人同時要避免長期臥床,因不活動會加速骨質流失與血鈣上升。延伸複習:病理性骨折的預防與活動安排、腎功能監測指標。",[24,26,28,30],{"term":25,"count":10},"雙磷酸鹽 zoledronic acid",{"term":27,"count":10},"蝕骨細胞抑制",{"term":29,"count":10},"高血鈣處置原則",{"term":31,"count":10},"Allopurinol 適應症",[33,37,42,47,52,57],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-115-1-medical-surgical-025","有關病人接受靜脈輸注化學藥物時，若不慎藥物外滲之護理措施，下列何者正確？",25,{"webId":38,"stem":39,"number":40,"year":41,"session":10},"nurse-106-1-medical-surgical-021","老年人骨質疏鬆症發生骨折之部位，下列何者最不常見？",21,106,{"webId":43,"stem":44,"number":45,"year":41,"session":46},"nurse-106-2-medical-surgical-035","章小姐在癌症治療過程中，向護理師反應「我快要死了，再也看不到我女兒了」，以庫伯勒-羅斯癌症病人的心理反應，是屬於下列那個階段？",35,2,{"webId":48,"stem":49,"number":50,"year":51,"session":46},"nurse-107-2-medical-surgical-073","有關康氏症候群（Conn’s syndrome）之臨床表徵，下列何者正確？",73,107,{"webId":53,"stem":54,"number":55,"year":56,"session":10},"nurse-109-1-medical-surgical-037","有關癌症病人血鈣之敘述，下列何者錯誤？",37,109,{"webId":58,"stem":59,"number":60,"year":61,"session":10},"nurse-110-1-medical-surgical-071","有關糖化血色素（HbA1c）檢查之敘述，下列何者正確？",71,110,"2026-08-06",1787299088782]